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一项使用两种不同方法对帕金森病轻度认知障碍认知训练效果的双盲随机对照试验:使用计算机工具带来益处的初步报告。

A double-blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods in mild cognitive impairment in Parkinson's disease: preliminary report of benefits associated with the use of a computerized tool.

机构信息

IRCCS Mondino Foundation, Pavia, Italy.

Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

出版信息

Aging Clin Exp Res. 2021 Jun;33(6):1567-1575. doi: 10.1007/s40520-020-01665-2. Epub 2020 Sep 8.


DOI:10.1007/s40520-020-01665-2
PMID:32895890
Abstract

BACKGROUND: The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. AIMS: To evaluate the efficacy of CCT in patients with Parkinson's disease and mild cognitive impairment (PD-MCI). METHODS: In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure. RESULTS: Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found. CONCLUSION: CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia. Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019).

摘要

背景:基于计算机的认知训练(CCT)的有效性仍存在争议,尤其是在患有神经退行性疾病的老年人中。

目的:评估 CCT 在帕金森病和轻度认知障碍(PD-MCI)患者中的疗效。

方法:在这项随机对照试验中,53 名患者被随机分为接受 CoRe 软件的 CCT、传统纸笔认知训练(PCT)或无结构活动干预(CG)。在每组中,干预持续 3 周(每周 4 次个体面对面会议)。在基线(T0)和干预后(T1)进行神经心理学评估。在 T0 和 T1 时比较组内和组间的结果测量值。蒙特利尔总体认知评估(MoCA)被用作主要结局测量指标。

结果:与 PCT 组和 CG 不同,接受 CCT 的患者在 MoCA 表现、整体认知、执行功能和注意力/处理速度方面表现出显著的中/大效应量改善。基线个体/人口统计学变量与干预后的更大收益无关,但与基线 MoCA 表现呈负相关。

结论:与传统的 PCT 相比,CCT 在 PD-MCI 患者中被证明是有效的。正在进行进一步的随访评估,以验证收益的保留和该工具延迟向 PD-痴呆转化的潜力。试验注册号(ClinicalTrials.gov):NCT04111640(2019 年 9 月 30 日)。

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[5]
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Brain Sci. 2025-1-11

[6]
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Front Psychol. 2025-1-9

[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Computer assisted cognitive rehabilitation improves visuospatial and executive functions in Parkinson's disease: Preliminary results.

NeuroRehabilitation. 2019

[2]
A computer-based cognitive training in Mild Cognitive Impairment in Parkinson's Disease.

NeuroRehabilitation. 2019

[3]
Evaluation of an ontology-based system for computerized cognitive rehabilitation.

Int J Med Inform. 2018-4-21

[4]
Cognitive Rehabilitation in Parkinson's Disease: A Systematic Review.

J Parkinsons Dis. 2018

[5]
Promising non-pharmacological therapies in PD: Targeting late stage disease and the role of computer based cognitive training.

Parkinsonism Relat Disord. 2017-9-4

[6]
Computerized Cognitive Training in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis.

Am J Psychiatry. 2016-11-14

[7]
Cognitive training in Parkinson disease: A systematic review and meta-analysis.

Neurology. 2015-11-24

[8]
Computer-based cognitive rehabilitation: the CoRe system.

Disabil Rehabil. 2017-2

[9]
MDS clinical diagnostic criteria for Parkinson's disease.

Mov Disord. 2015-10

[10]
Improving functional disability and cognition in Parkinson disease: randomized controlled trial.

Neurology. 2014-12-2

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